Book Honorarium Form
I wish this gift to be made: _______ In Honor of _______ In Memory of
Name: _____________________________________
This gift was given by:
Name: ______________________________________________________
Address: _____________________________________________________
Phone #:________________________________
Email:__________________________________
Please Send Acknowledgement to (one acknowledgement please) ____________________________________________________________
____________________________________________________________
You may personalize your memorial/honorarium gift with a 30 character sentence/expression. (i.e. – friend of the library; loved children’s story time or avid sportsmen).
Gift Amount: $___________ Check # ___________ Cash ___________
Please make your check payable to: ECPL Book Endowment, Erie Regional Library Foundation, Inc., Blasco Library, 160 East Front Street, Erie, PA 16507. For more information please call 814-451-6952.
Thank you for thinking of the library.
